A study published Tuesday in the Annals of Internal Medicine questions whether there’s enough emphasis on the risks of statins, compared to the benefits. 

“Most studies haven’t looked for side effects. So, it’s very important that a study like this brings up the possibility of side effects,” says Paul D. Thompson, a statin expert and chief of cardiology at Hartford Hospital in Connecticut. “It’s an important paper—it opens debate.”

There’s solid evidence for the benefits of statins. They lower the risk of heart attack, stroke, and deaths from heart-related causes. So, if you’re at risk for cardiovascular disease your doctor will likely prescribe a statin. 

Their use is widespread. Almost 39 million Americans take statins. They are prescribed for 28% of people age 40 and up, and 48% of people age 75 and up. 

Risks are real

But statins aren’t all upside. The drugs are linked with muscular disorders, liver and kidney problems, cataracts, hemorrhagic stroke, type 2 diabetes, cancer, nausea, and headache.

Researchers suspected that the recommendations for statins focused more on the benefits than the risks. So, they compared men and women age 40 to 75 who took statins with those who did not. 

They found that the benefits vs. risks of statins can vary based on age and gender, as well as on the type of statin.

Statins are generally prescribed for people who have a 7.5 to 10% risk of cardiovascular disease in the next 10 years, regardless of their age or gender. 

But according to this study, that guideline may be low.

What they found

Researchers found that younger men—age 40 to 44—needed a 14% or higher 10-year risk of cardiovascular disease before they could expect to see the benefits of statins outweighing the risks.

For older men, age 70 to 75, that number rose to 21%.

Younger women—age 40 to 44—saw that benefits outweighed risks when their 10-year cardiovascular disease risk hit 17%. 

For older women, age 70 to 75, that number climbed to 22%.

Statins and you

And not all statins are the same, so the researchers separately examined four commonly prescribed statins. They found that atorvastatin and rosuvastatin scored better than pravastatin and simvastatin in terms of benefits outweighing risks.

Thompson cautions that further research is needed to examine the study’s results. “Maybe the risk group should be higher before we treat, but I wouldn’t make big changes based on one paper,” he says.

Should you re-evaluate your use of statins?

“Patients should have a doctor they trust who they can talk this over with. These are not simple decisions,” Thompson says.

“But statins really are lifesaving drugs,” he adds. “They prevent a lot of cardiac events in the right population. My thoughts are that the benefits outweigh the risks.”

•December 5, 2018